Information Collection Request

Medicare Advantage, Medicare Part D, and Medicare Fee-For-Service Consumer Assessment of Healthcare Providers and Systems (CAHPS) Survey (CMS-R-246)

ICR 201706-0938-003 · OMB 0938-0732 · Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form CMS-R-246 Medicare Advantage (MA) Survey Form and Instruction Modified Available
Form CMS-R-246 MA-PDP Survey Form and Instruction Modified Available
Form CMS-R-246 Fee-For-Service (FFS) Survey Form and Instruction Modified Available
Form CMS-R-246 MA and PDP Contracts Form and Instruction Removed Available
MCAHPS - Crosswalk 2017 - 032718 CLEAN.xlsx Supplementary Document Uploaded 2018-04-05 Available
CMS-R-246 - Supporting Statement A - Passback2 - 032218 CLEAN.docx Supporting Statement A Uploaded 2018-04-05 Available
CMS-R-246 - Supporting Statement B.docx Supporting Statement B Uploaded 2017-07-17 Available
Response_to_Comments_60_FRN_CMS-R-246.docx Supplementary Document Uploaded 2017-07-17 Repair queued

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
8404 Medicare Advantage (MA) Survey Form and Instruction Modified
194258 MA-PDP Survey Form and Instruction Modified
194257 Fee-For-Service (FFS) Survey Form and Instruction Modified
194256 MA and PDP Contracts Form and Instruction Removed

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
04/30/2021 36 Months From Approved 07/31/2018
799,650 0 800,249
192,113 0 310,086
0 0 2,995,000






Reginfo record details
3
table that charts list of burden
IC Title Form No. Form Name
Medicare Advantage (MA) Survey CMS-R-246 Medicare Advantage Plan Survey
Fee-For-Service (FFS) Survey CMS-R-246 Fee-For-Service (FFS) Survey
MA-PDP Survey CMS-R-246 Prescription Drug Plan Survey
MA and PDP Contracts CMS-R-246, CMS-R-246 MA-only Survey ,   MA-PD Survey

table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 799,650 800,249 0 0 -599 0
Annual Time Burden (Hours) 192,113 310,086 0 -85,627 -32,346 0
Annual Cost Burden (Dollars) 0 2,995,000 0 0 -2,995,000 0


Reginfo record details
  No